How effective is antibiotic therapy for acute otitis media (AOM)?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

A randomized, double-blind, placebo-controlled study indicated that in children with AOM, antimicrobial treatment may prove most beneficial for those with a severely bulging tympanic membrane, while initial observation may be the best course for children with a peaked tympanogram (A and C curves). The study involved patients aged 6 to 35 months. [22, 23]

Results from another randomized, placebo-controlled study indicated that antimicrobial treatment of AOM-related middle ear effusion is effective even in older children. In the Finnish study, of 84 children aged 6 months to 15 years, 50% of the patients were treated with antibiotics, with middle ear effusion resolving an average of 2 weeks earlier in these children than it did in patients who did not receive antibiotics. Reduction of mean duration of ear effusion by age was as follows [24, 25] :

  • < 2 years: 8 days

  • Age 2-6 years: 20 days

  • >6 years: 1 day


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